HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McLarney, J. K. Articles by Ros, P. R. Search for Related Content PubMed PubMed Citation Articles by McLarney, J. K. Articles by Ros, P. R. Related Collections Gastrointestinal Radiology

From the Archives of the AFIP

Fibrolamellar Carcinoma of the Liver: Radiologic-Pathologic Correlation

¹ Departments of Radiologic Pathology (J.K.M., P.T.R., G.N.B., N.K., P.R.R.)
² Hepatobiliary Pathology (Z.D.G.), Armed Forces Institute of Pathology, 14th and Alaska Sts, NW, Washington DC 20306
³ Department of Radiology, Okayama University, Japan (N.K.)
⁴ Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (P.R.R.)

Fibrolamellar carcinoma is a malignant hepatocellular tumor with distinct clinical and pathologic differences from hepatocellular carcinoma. It differs from hepatocellular carcinoma in demographics, condition of the affected liver, tumor markers, and prognosis. Fibrolamellar carcinoma characteristically manifests as a large hepatic mass in adolescents or young adults (without gender predominance). Cirrhosis; elevated -fetoprotein levels; and typical risk factors for hepatocellular carcinoma such as viral hepatitis, alcohol abuse, and metabolic disease are typically absent. Fibrolamellar carcinoma is characterized pathologically by cords of tumor cells surrounded by abundant collagenous fibrous tissue arranged in a parallel or lamellar distribution. Fibrotic lamellae often coalesce to form a central scar. Fibrolamellar carcinoma characteristically appears on radiologic images as a lobulated heterogeneous mass with a central scar in an otherwise normal liver. Radiologic evidence of cirrhosis, vascular invasion, or multifocal disease—findings typical of hepatocellular carcinoma—is uncommon in fibrolamellar carcinoma. Imaging features of fibrolamellar carcinoma overlap with those of other scar-producing lesions including focal nodular hyperplasia (FNH), hepatocellular adenoma and carcinoma, hemangioma, metastases, and cholangiocarcinoma. FNH, in particular, may simulate fibrolamellar carcinoma, since both have similar demographic and clinical characteristics. Because some believe that radiologic diagnosis of FNH is possible, it is important to understand the imaging appearance of fibrolamellar carcinoma to avoid misdiagnosing this malignant tumor as a FNH.

Index Terms: Liver neoplasms, 761.324 • Liver neoplasms, MR, 761.12141

This article has been cited by other articles:

				M. T. Smith, E. R. Blatt, P. Jedlicka, J. D. Strain, and L. Z. Fenton Best Cases from the AFIP: Fibrolamellar Hepatocellular Carcinoma RadioGraphics, March 1, 2008; 28(2): 609 - 613. [Full Text] [PDF]

				P Manoharan and J Ward MRI in the assessment of focal liver lesions in the non-cirrhotic patient Imaging, September 1, 2004; 16(4): 338 - 350. [Abstract] [Full Text] [PDF]

				F. M. Fennessy, K. J. Mortele, T. Kluckert, A. Gogate, S. Ondategui-Parra, P. Ros, and S. G. Silverman Hepatic Capsular Retraction in Metastatic Carcinoma of the Breast Occurring with Increase or Decrease in Size of Subjacent Metastasis Am. J. Roentgenol., March 1, 2004; 182(3): 651 - 655. [Abstract] [Full Text] [PDF]

				S. M. Hussain, T. Terkivatan, P. E. Zondervan, E. Lanjouw, S. de Rave, J. N. M. IJzermans, and R. A. de Man Focal Nodular Hyperplasia: Findings at State-of-the-Art MR Imaging, US, CT, and Pathologic Analysis RadioGraphics, January 1, 2004; 24(1): 3 - 17. [Abstract] [Full Text] [PDF]

				S. M. Hussain, P. E. Zondervan, J. N. M. IJzermans, S. W. Schalm, R. A. de Man, and G. P. Krestin Benign versus Malignant Hepatic Nodules: MR Imaging Findings with Pathologic Correlation RadioGraphics, September 1, 2002; 22(5): 1023 - 1036. [Abstract] [Full Text] [PDF]

				T. Ichikawa, M. P. Federle, L. Grazioli, and W. Marsh Fibrolamellar Hepatocellular Carcinoma: Pre- and Posttherapy Evaluation with CT and MR Imaging Radiology, October 1, 2000; 217(1): 145 - 151. [Abstract] [Full Text]

				A. Blachar, M. P. Federle, J. V. Ferris, J. M. Lacomis, J. S. Waltz, D. R. Armfield, G. Chu, O. Almusa, L. Grazioli, E. Balzano, et al. Radiologists' Performance in the Diagnosis of Liver Tumors with Central Scars by Using Specific CT Criteria Radiology, May 1, 2002; 223(2): 532 - 539. [Abstract] [Full Text] [PDF]